This study will analyze the impact of the regulation on youth cigar use, and will answer: Has the regulation resulted in a reduction in cigar use prevalence among 9-12 graders in Boston after its enactment in 2012? Was the reduction in cigar use prevalence among 9-12 graders in Boston greater than those of municipalities that have not enacted the regulation? To what extent has the sales price of cigars increased in retail stores since the enactment in 2012?

In 2012, Boston implemented a board of health regulation prohibiting the sale of cigars unless they come in original packages of at least four. Any cigar costing more than $2.50 is exempted from the 4-pack requirement. Only Baltimore and one county in Maryland have attempted to enact this type of regulation. The rising rate of youth cigar use is a significant public health issue. Tobacco use is the number one preventable cause of preventable death and disease in the US and costs the country $193 billion annually.